Chapter 9/19

Sacrum/Coccyx

Sacrum

• 5 fused vertebrae

• 4 sets of ________________– Pelvic (Anterior) & Posterior

Sacrum

• _________ – Wings of sacrum

• Superior articulating process– ______________formed with 5th l-spine

vertebra inferior articulating process

Sacrum

• _____________ – Anterior protrusion

• _____________– Continuation of vertebral Foramen

Sacrum

• ________________– Fused spinous processes

• _______________– Joint surface of SI joint

• ______________– Inferior articulating process

Coccyx

• Tailbone

• ___________coccyx segments

• Most distal aspect of spinal column

Coccyx

• Transverse process

• _________

• _________

• Larger at the base and cones toward apex

Imaging the sacrum

Routine• AP• Lateral• 80 kVp

AP Sacrum

• Pt supine

• _____________tube angle

• Between _________________

• CR mid sagittal and _________to ASIS

Lateral Sacrum

• Pt in true lateral

• Flex knees

• CR at the __________and __________to posterior sacral surface

• Or _____________to ASIS

Imaging the Coccyx

Routine• AP• Lateral• 75 kVp

AP Coccyx

• Pt supine

• ___________angle

• _____________to Symphysis Pubis

• CR Mid sagittal and ______________

Lateral Coccyx

• Pt in true lateral• Knees flexed• ______________to ASIS• ______________to ASIS• Collimate Close all 4 sides

Chapter 22

Myelogram

Myelogram

• Study to look at spinal cord and nerves root branches

• Indications – _____________– ____________________

Myelogram

• Requires an injection into the ________________

• Menenges– Dura Mater– _________– Pia Mater

Contraindications• Sensitivity to Iodine

• Blood in ___________

• Arachnoiditis

• Increased _____________

• Recent _________

Equipment

• Myelogram tray

• X-ray table that can ______________– Foot board– Shoulder holder

• X-table cassette holder

Equipment

• _______

• X-table holder

• Pillow for abdomen

• ______________________

Contrast• Water Soluble – ___________

• Marked for ____________ Use

Injection

• X-table and AP scout

• Done by radiologist

• Lumbar – ________– Through ______________

Injection

• Cervical– _______________bone

• Injected _____________to avoid excessive mixing of contrast and _____

Lumbar injection

• Generally ___________– Spinal cord branches and not solid

• Pt prone– Pillow ____________to open disc spaces

• Lt Lateral with spine __________• Sterile

Cervical Injection

• Done if Lumbar is contraindicated

• Pt sitting ________ with neck _________

• Or pt __________ with neck flexed

• Contrast should not enter _________– ___________the neck

What happens

• A ___________is done first– Evaluates appearance of CSF (blood present)

• Contrast injected– Make sure it is __________use

What Happens

• Needle is removed

• Pt is tilted _________________________– By gravity contrast is spread through the

spinal canal

Imaging • __________ has taken over

• Cervical – X-Table, X-table swimmers

• Thoracic– Lateral, X-Table, AP/PA

• Lumbar– Semierect X-Table, X-table lateral, AP/PA,

Obliques

Post Exam Care

• Bandage the injection site

• Place pt semi erect _______________.

• Restricted to the bed.

Complications

• Air into the ____________ of the brain• Spinal needle irritating nerves• Excessive ______________ bleeding• Contrast into ventricular areas

– Can cause _______________• Reaction to contrast